Soloperto, Davide1; Marchioni, Daniele1
1ENT Department, AOUI Verona, Italy.
Middle and inner ear malformations are present in about 30% of all cases of congenital hearing loss. The aim of present study is to describe the use of the endoscopic assisted cochlear (CI) and auditory brainstem implant (ABI) surgery in cases with severely malformed temporal bones and with anomalous anatomy of the inner ear and tympanic cavity.
Patients with complex ear malformations and deafness, selected in our tertiary referral center between January 2013 and December 2018, that underwent surgery for CI and/or ABI with endoscopic assisted approach were analyzed.
A retrospective chart review of all data and videos was performed.
Main Outcome Measures:
Patients characteristics, preoperative audiologic and neuroradiologic assessment, data collected during the surgery and postoperative conditions were analized.
Even in case of complex malformations, the procedure was always completed with endoscopic assisted approach. Intraoperative neural responses (NRT) were good in all patients. No major complications, even in case of ABI, were observed postoperatively. After 1 month, the implant was activated, with good hearing improvement.
Endoscopic assisted approach for CI and ABI proved to be successful, it guaranteed a very good control on the site of cochleostomy and facial nerve course, even in cases with difficult anatomical conditions. It also provides superior visualization of the lateral recess of the fourth ventricle than the operating microscope in retrosigmoid approach for ABI surgery.